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Outcome of surgery and radiotherapy for dermatofibrosarcoma protuberans: 5-year experience from two tertiary centers of eastern India

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objective

Dermatofibrosarcoma protuberans (DFSP) is a relatively rare cutaneous soft tissue tumor that is locally aggressive, characterized by high rates of local recurrence, but low risk of metastasis. Wide radical excision is the preferred treatment for DFSP, but local recurrence rates of up to 60% after surgery alone have been documented in cases of close or compromised margin. Adjuvant radiotherapy has been used to reduce such recurrences.

Methods

A retrospective audit of patients of DFSP in two tertiary care hospitals of eastern India treated radically by surgery with or without adjuvant radiotherapy was undertaken. A cohort of 16 patients receiving treatment between January 2010 and December 2015 was evaluated for presentation, diagnosis, treatment, local control, toxicity, and disease-free survival.

Results

The mean age of presentation was 46 years with the range from 17 to 71 years, with 9 out of 16 being females. All patients underwent wide local excision except in two cases, with 8 patients undergoing re-resections after initial excision biopsy. A total of 12 out of 16 patients had less than 2-cm margin, and six had close deep resection margin. Of 16 patients, 10 received adjuvant radiotherapy. With the median follow-up of 39 months, four patients have developed recurrence, three in the surgical cohort and one in the radiotherapy cohort. Two patients in the surgical cohort who have developed recurrence had excision with close margin, and use of postoperative radiotherapy in them was withheld in view of increased risk of toxicity.

Conclusion

Combined modality therapy with surgery and radiotherapy for cases of close or inadequate margin results in good local control with acceptable toxicity, in cases where re-surgery is not possible or not contemplated.

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Authors and Affiliations

  1. Medical College and Hospital, Kolkata, India

    Anis Bandyopadhyay

  2. Rampurhat Government Medical College & Hospital, Rampurhat, West Bengal, India

    Siddhartha Biswas

  3. Institute of Post Graduate Medical Education and Research, Kolkata, India

    Harris Mahammad Sepai

  4. Medical College and Hospital, Kolkata, India

    Poulami Basu & Arnab Kumar Ghosh

Authors
  1. Anis Bandyopadhyay
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  2. Siddhartha Biswas
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  3. Harris Mahammad Sepai
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  4. Poulami Basu
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  5. Arnab Kumar Ghosh
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Correspondence to Harris Mahammad Sepai.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

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Bandyopadhyay, A., Biswas, S., Sepai, H.M. et al. Outcome of surgery and radiotherapy for dermatofibrosarcoma protuberans: 5-year experience from two tertiary centers of eastern India. J Radiat Oncol 8, 405–412 (2019). https://doi.org/10.1007/s13566-020-00412-4

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  • DOI: https://doi.org/10.1007/s13566-020-00412-4

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